Maxillofacial trauma is common in the emergency department as ~80% of patients with polytrauma sustain injuries to the head, face, and/or neck. The most common etiologies of facial fractures are: assault (36%), motor vehicle accidents (32%), falls (18%), sports injuries (11%), occupational injuries (3%), and gunshot wounds (2%).3 The most commonly fractured facial bones are (in descending order): nasal bones, orbital floor, zygomaticomaxillary complex, maxillary sinuses, mandibular ramus, and the nasoethmoidorbital. This post will review the general approach to evaluation of maxillofacial trauma in the ED followed by specific management recommendations for various fracture patterns.